美国DRGs发展演变、支付特征及对我国的启示  

Development,Evolution and Features of DRGs in the United States and Enlightenment for China

作　　者：王海银 周佳卉 房良 彭颖 金春林 WANG Haiyin;ZHOU Jiahui;FANGLiang(Shanghai Health Development Research Center/Medical Information Center,Shanghai,200042,China)

机构地区：[1]上海市卫生和健康发展研究中心/医学科学技术情报研究所,上海200042

出　　处：《中国卫生质量管理》2018年第6期25-27,共3页Chinese Health Quality Management

基　　金：上海市医药卫生体制改革循证决策与政策转化(CMB-CP-14190);上海市公共卫生重点学科建设项目(卫生经济学)(12GWZX0601)

摘　　要：按疾病诊断相关分组付费是国际上对住院患者的主流医保支付方式,该支付方式起源于美国,现已在全球多个国家发展和应用。从DRGs理论设计及演变、支付特征及实践应用等维度深入分析美国DRGs发展历程,总结美国DRGs设计的特点及存在问题,结合我国实际,提出美国DRGs发展对我国按疾病诊断相关分组预付费改革的启示和政策建议。The DRGs-based prospective payment system （DRGs-PPS） is mainstream inpatient care payment mechanisms in most countries, which was originated in the United States, and developed and applied many countries around the world. This paper provided an overview of the United States DRGs theory design and evolution characteristics, and the application, summarized the DRGs design characteristics and existing problems. Combining the reality of China s reform, and some suggestions were put forward for promoting DRGs PPS reform in China.

关 键 词：美国 疾病诊断相关分组 演变 特征 启示 

分 类 号：R197.1[医药卫生—卫生事业管理]